HomeMy WebLinkAboutX2020-2313 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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OWNER'S NAME Last 11A_",
Owner's Address
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APPLICANT'S NAME Last I ",_`%LU/A
Applicant's AddressYe
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ARCHITECT/DESIGNER'S NAME Last �A/%
Architect/Designer's Address
City State -�
First
Owner's E-mail Address
Zip
First
Applicants E-mail
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l Address ,,/-t
Zip ` ZT Telephone e
j First Lic.No - 225
ArchitectlDesigner's E-mail Address
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Zip L� Telephone��',
ENGINEER'S NAME Last _ — First!.
Engineer's Address
City -_.. State
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City — --- -- State
Lic. No.F7___—�
Engineer's E-mail Address
Zip �I, Telephoned JAI
Lic.
Contractor's E-mail Address
Zip , Telephoned
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PERMIT NO. ZUZ-0 z3 1 .
SETBACKS REAR SETBACKS FRONT —_ (
SETBACKS LEFT pQ
SETBACKS RIGHT PLAN CHECK NO. V S Z
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USEZONE DEVELOPMENT NO
PLAN CHECK FEES $